Senator Warren Pushes for Medical Marijuana Research

February 18, 2016

In an effort to combat the growing epidemic of deaths due to opioid overdose, Senator Elizabeth Warren (D-Mass) is urging the Centers for Disease Control and Prevention to step up medical marijuana research.

The war on pain has led to a new awareness of the undertreatment of pain, yet as opioid prescriptions almost doubled in the last decade,1 a harsh light has been cast on the rise in drug misuse, abuse, addiction, overdose, and death.2

In 2013, nearly 2 million Americans aged 12 or older either abused or were dependent on opioid drugs, according to the Centers for Disease Control and Prevention (CDC).3 In that same year, more than 16,000 Americans died from overdoses related to prescription opioid drugs.3

The CDC recently announced plans to draft a guideline on prescribing opioids for chronic pain. The guidelines, which will be intended for patients 18 or older, will include a number of clinical practices, including:

The guidelines also reportedly will cover follow-up and discontinuation of opioid therapy (weaning), review of prescription drug monitoring program data, use of urine drug testing, use of opioids and benzodiazepines, arrangement of treatment for opioid use disorder, and other important areas.3

Massachusetts Senator Elizabeth Warren commended the CDC for their plan to build a consensus guideline on this topic, stating in a letter to Thomas Frieden, MD, MPH, director of the CDC, that “the guidelines are an important step.”

However, while Sen. Warren commended the CDC for the guideline, she also stressed the importance of collaborating with the National Institutes of Health, the Substance Abuse and Mental Health Services Administration, and Drug Enforcement Administration to investigate other important topics, such as the use of medical marijuana (MM) as an alternative form of pain management.

Medical Marijuana – Promising Yet Contested

Sen. Warren recommended further research be done to explore the efficacy of MM, studies which can be conducted in the 23 states where MM is currently legal, including Massachusetts, New York, and DC. Such studies already have begun to expound the legitimate benefits of MM as a form of pain management for a number of cancer and noncancer conditions.

However, marijuana’s issues with legality, especially with the discrepancy between the state and federal jurisdictions, still impose a barrier to facilitating research and development into the substance’s clinical and biomedical prospects.

Senator Warren also in her letter urged the CDC to explore “the impact of the legalization of medical and recreational marijuana on opioid overdose deaths.” Interestingly, some research already has explored this topic, finding that states with MM had lower annual opioid overdose death rates by 24.8%.8

Other Issues: Pediatric Opioid Use and Physician Opioid Training

Sen. Warren also urged the CDC to look more into the long term effects that opioids may have on children treated at a young age. Unfortunately, this is a topic the proposed guidelines will not cover since they apply only to patients 18 years or older.

The topic of pediatric opioid use is a significant one, though. Research on pediatric opioid use, in general, is scant. Still, this did not stop the FDA from approving the use of OxyContin in pediatric patients last August. And yet this month, the FDA also released its own initiatives for combating the opioid abuse epidemic, including an intention to assemble a Pediatric Advisory Committee specifically for approving any new pediatric opioid labeling in the future.

Sen. Warren also mentioned the contested topic of fentanyl, a powerful synthetic opiate analgesic superior in potency to morphine, which she believes deserves more attention, particularly its possible contribution to opioid overdoses and deaths. Current status quo of pain management training for medical students also may require reform, as the current allotted teaching time to the subject is noticeably inefficient, according to experts.

More information about the CDC’s guideline, including the content, methodology, and scope of the guidelines, can be found here.

Centers for Disease Control and Prevention. Prescription Drug Overdose in the United States: Fact Sheet. Updated October 17, 2014. http://www.cdc.gov /homeandrecreationalsafety/overdose/facts.html. Accessed October 22, 2014.

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